title: Distress and the parenting dynamic among BRCA1/2 tested mothers and their partners.
abstract: OBJECTIVE
  To investigate the influence of dyadic parenting relationships on psychological distress among mothers tested for BRCA1/2 genetic mutations and their untested partners.
  
  
  METHODS
  Data were from a prospective study of mothers suspected to be at risk for hereditary breast/ovarian cancer who underwent genetic counseling and BRCA1/2 testing and their untested parenting partners (n = 109 parenting dyads). Participants completed assessments before and 1 month after genetic testing. Structural equation modeling was used to examine relationships among mothers' and partners' psychological distress, decisional conflict surrounding communication of test results to their offspring, and the parent-child communication relationship. Psychological distress was measured using items modified from the Brief Symptom Inventory.
  
  
  RESULTS
  Among mothers, greater psychological distress (B = 0.29, p < .001) and poorer parent-child communication (B = -0.12, p < .01) at baseline predicted greater distress at follow-up. Among partners, greater distress at baseline predicted greater distress at follow-up (B = 0.67, p < .001). Mother and partner decisional conflict at baseline were equally associated with the other dyad member's distress at follow-up (B = 1.17, p < .01), but not their own distress.
  
  
  CONCLUSIONS
  Our findings indicate that conflicted decision-making over family communication of hereditary breast/ovarian cancer genetic test results for one member of a parenting dyad adversely affects the other dyad member's psychological well-being. Interventions to improve outcomes for mothers who may be at-risk for hereditary breast and ovarian cancer and undergoing BRCA1/2 genetic testing should attend to mothers' and their partners' preferences regarding family communication about hereditary cancer risk.
authors.affiliation: Cancer Prevention & Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center.
authors.forename: Darren
authors.initials: D
authors.lastname: Mays
authors.affiliation: Cancer Prevention & Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center.
authors.forename: Tiffani A
authors.initials: TA
authors.lastname: DeMarco
authors.affiliation: Department of Biostatistics, Bioinformatics, and Biomathematics, Cancer Prevention & Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center.
authors.forename: George
authors.initials: G
authors.lastname: Luta
authors.affiliation: Cancer Prevention & Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center.
authors.forename: Beth N
authors.initials: BN
authors.lastname: Peshkin
authors.affiliation: Department of Psychosocial Oncology & Palliative Care, Dana-Farber Cancer Institute.
authors.forename: Andrea F
authors.initials: AF
authors.lastname: Patenaude
authors.affiliation: Center for Cancer Genetics & Prevention, Dana-Farber Cancer Institute.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Schneider
authors.affiliation: Center for Cancer Genetics & Prevention, Dana-Farber Cancer Institute.
authors.forename: Judy E
authors.initials: JE
authors.lastname: Garber
authors.affiliation: Cancer Prevention & Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center.
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Tercyak
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000235:genetics; D002648:Child; D003142:Communication; D003220:Conflict, Psychological; D003657:Decision Making; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D009154:Mutation; D010051:Ovarian Neoplasms / Q000235:genetics; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology*; D011446:Prospective Studies; D012747:Sexual Partners / Q000523:psychology*; D013315:Stress, Psychological